Peanut WA
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(9/18/01 3:15 pm)
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Patterns of Affective Illness Change
WESTPORT, CT (Reuters Health) Aug 31 - Young children with affective illness do not typically present with the same symptoms as older adolescents, according to a report in the August issue of the Journal of Child Neurology. Being aware of these differences may help physicians and other pediatric healthcare providers to recognize and treat affective illness earlier in this population, leading to better long-term outcomes.
Dr. Warren A. Weinberg, a researcher at the University of Texas Southwestern Medical Center, in Dallas, and colleagues examined the presentation of affective illness in 100 consecutive patients, ages 2 to 20 years, who were evaluated in a single pediatric behavioral neurology program. Of these patients, 65 were prepubertal children and 26 were fully pubertal adolescents (nine patients were classified as Tanner stage 2, an intermediate stage of development).
The researchers identified seven patterns of affective illness. Of these, hypomanic/manic symptoms predominated in the prepubertal children (47 of 65 subjects) and depressive symptomatology predominated in adolescents (16 of 26 subjects).
"Hypomanic/manic symptoms can be easy to overlook in young children if not considered in the evaluation process," and can be mistaken for symptoms of attention-deficit/hyperactivity disorder (ADHD) or other conduct disorders, Dr. Weinberg explained in an interview with Reuters Health.
In fact, he suggested that the "study adds further support that ADHD may be a myth, with the hyperactive/impulsive form of ADHD in young children representing affective illness."
The team also found a strong link between affective illness of all patterns and family history of drug and alcohol abuse, character disorder and Briquet's syndrome. They speculate that this link may represent evidence of a genetic basis for affective illness.
Physicians should be aware of the changing presentation of affective illness, as well as its association with family history, in pediatric patients to ensure early and correct identification, according to Dr. Weinberg. "Early recognition of pattern presentation leads to appropriate and successful management in all age groups...If not recognized, this treatable illness will continue with high morbidity and even mortality (suicide and homicide)."
J Child Neurol 2001;16:553-561.
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